Objective To investigate the clinical efficacy of nifedipine sustained-release formulation(SR)and nifedipine controlled-release(GITS)in the treatment of essential hypertension.Methods 160 patients with essential hypertension were randomly divided into two groups.The SR group was treated with SR 20 mg twice a day;GITS group was treated with GITS 30 mg once a day.All patients were given ambulatory blood pressure monitoring(ABPM)and observed the 24-hour average blood pressure,heart rate,changes in the trough/peak(T/P)values,and adverse reactions before and after treatment in two groups.Results The T/P value of systolic blood pressure(SBP)and diastolic(DBP)in the GITS group was 68.5％,74.6％,respectively,which were higher than those of SR group(57.2％,61.1％)(x2=6.32,7.05,all P＜0.05);GITS group was significantly lower than the SR group in heart rate(t=4.17,P＜0.05);Adverse reactions between two groups had no significant difference(x2=0.16,P＞0.05).Conclusion SR and GITS can effectively lower blood pressure,but GITS is more efficient,stable,safe,small impact on the heart rate.

Objective To find an effective method for the treatment of mitomycin C extravasation injuries. Methods The rabbit model of mitomycin C extravasation was made and managed by different methods. The therapeutic efficacy in each group was assessed by using regression index and regression time. Results The therapeutic efficacy in ice compress group and ice compress plus amifostine group was better than that in other groups and the regression time was the shortest. There was no inflammation and necrosis in skin in ice compress group. Conclusion Ice compress, which can prevent inflammation and necrosis in skin, is one of the most effective treatment methods for mitomycin C extravasation injuries.

Objective To observe the morphological changes of corneal nerve in experimental herpes simplex keratitis (HSK) in rabbit eyes. Methods Inoculation of the scarified cornea with herpes simplex virus-Ⅰ(HSV-Ⅰ)leads to herpetic infection of cornea. The HSK was detected by slit lamp and polymerase chain reaction(PCR), and the changes of corneal nerves in various periods with methylene blue vital staining and ultrastructure of corneal nerve were studied. Results Under light microscope, fewer corneal nerve bundles were observed, scattered with lower density of nerve fiber at center of cornea on the 4th day after the infection. At days 7 and 14, the seriously damaged nerve fiber was intermittent. The neuraxon became shorter with little polarity and the density of nerve fiber was extremely low. At day 30, the density was still low while the nerve fiber was approximately normal. Under electromicroscope, at day 4, the lamellar sheath of nerve fiber in the epitheliums appeared intermittent, and the neuroplasm of endings was partly lysed. During day 7 to day 14,neuroplasm was damaged and became vacuolar. The mitochondria swelled with vacuolar crest, and then were destroyed and lysed. The nerves in stroma were also injured. On day 30, neurilemma sheath was still intermittent with the decrease of microfilament and racuole. Conclusion HSK leads to the damage of nerve and the decrease of nerval density, and the damage of corneal nerve repairs very slowly.

Objective To investigate the application value of anatomic segmental hepatectomy in treatment of left hepatolithus.Methods The 80 patients with left hepatolithuswere divided into the control group (n =40)and the observation group (n =40)in accordance with dif-ferent surgical methods,and they were given traditional surgery and precise pedicle anatomic segmental hepatectomy respectively.Operation index levels,postoperative complications and stress reaction levels before and after surgery of the two groups were compared.Results The blood loss,operative time,the time of drainage tube remove,time of analgesic drug use,and postoperative hospital stay of the observation group were significantly less than the control group,and the difference was statistically significant (P <0.05).The rate of postoperative com-plications was 17.50% in the control group,while it was 15.00% in the observation group,which showed no significant difference between the two groups (P >0.05).During the surgery,epinephrine,cortisol,IL-6 and CRP levels of patients decreased after a slight increase, while NK cell levels of patients decreased firstly and then increased.There were statistically significant differences in trems of the above inde-xes immediately after surgery to 24 hours after surgery (P <0.05),and the rangeability of the observation group was less than the control group (P <0.05).Until 48 hours after surgery the above indexes recovered to the preoperative level.Followed up for 3 to 24 months,the calculi recurrence rate and abdominal ache recurrence rate of the observation group were lower than the control group,and the difference was statistically significant(P <0.05).Conclusion Precise pedicle anatomic segmental hepatectomy applied in the treatment of left hepatolithus showed makedly curative effect,and it has little effect on the stress response of patients.

OBJECTIVE:To study the percutaneous absorption of 0.03% Tacrolimus ointment,and to compare the difference of domestic test preparation and imported reference preparation. METHODS:Modified Franz diffusion cells were adopted in trans-dermal test in vitro;HPLC-MS method was used to determine permeation amount and rate in vitro,delay time of domestic test preparation and imported reference preparation 0.03%Tacrolimus ointment. RESULTS:24 h in vitro permeation amount of test and reference preparations were(3 907±1 191)and(3 896±1 064)ng/cm2;permeation rates were 186.7 and 182.9 ng/(cm2·h);de-lay time were 1.95 and 2.00 h,respectively(P>0.05). CONCLUSIONS:Test preparation shows good percutaneous property,and is similar to reference preparation in penetration absorbency through nude mice skin.

Objective To discuss the CT features and the prognosis of hypoxic ischemic encephalopathy (HIE) with intracranial hemorrhages in neonates.Methods The CT features of the HIE with intracranial hemorrhage were analyzed and follow-up studied in 64 cases.Results Of all the 64 cases with HIE, 53 cases were associated with subarachnoid hemorrhage (SAH), and all cases were normal in the follow-up study after 1 month. 1 case was associated with intraventricle hemorrhage (IVH), 10 cases were associated with mixed bleeding (SAH+IVH in 3 cases, IVH+IPH in 1 case, SAH+IPH in 2 cases, SAH+SHE in 2 cases, SAH+SDH in 2 cases). Of the follow-up studies on 10 mixed bleeding cases, 1 was normal, 1 was dead, and the others were cerebromalacia, cerebral atrophy, porencephaly and calcium.Conclusion Different intracranial hemorrhages results in different prognosis.

Objective:To summarize the oblique branches found in the transfer of anterolateral thigh flap (ALTF) and to handle the issues of oblique branch.Methods:Thirty patients who require surgery of ALTF transfer from May, 2017 to October, 2019 were enrolled. CTA examination was perfected prior surgery and the origin of ALTF vessels was preliminarily determined. During the surgery, Three-longitudinal-and-five-transverse methods were used to locate and design the flap. The ALTF was taken according to the flap design. Attention should be paid to the location of the oblique branch and the separation of the vessels of oblique branch to avoid a damage as much as possible. The vessels of oblique branch should be completely explored and separated. One or 2 vascular pedicles were cut according to whether the oblique branch vessels and the descending branch vessels were joined together during surgery. Clamping tests were carried out on the 2 vascular pedicles to determine an arterial blood supply. Super drainage of vascular pedicle veins according to the situation of blood circulation. After the surgery, routine treatment was carried out. Blood supply, skin temperature, swelling degree, exudation and survival of the flap were closely observed and regular follow-up was carried out.Results:Among the 30 ALTF examined by CTA, 13 patients were identified with oblique branch vessels before operation. During operation, 11 oblique branch vessels (The occurrencce rate was 36.6%)were found to enter the flap, and were completely preserved. Of the 11 identified oblique branch vessels, 8 had 2 vascular pedicles taken and the vascular pedicles were treated by venous super drainage technique. The postoperative blood supply of the flap was good; The skin temperature was closed to surrounding normal skin; Swelling of flap was minor and there was little seepage. The flaps all survived after surgery with stage one healing. Followed-up time was 3-32 (average 16.1) months. The recipient site healing was good, and the function and appearance were satisfactory. The joint movement at the donor site was normal, and there was no obvious loss of local sensation.Conclusion:More than one third of the oblique branches appear in this group. The oblique branch vessels should be preserved as much as possible to avoid issues in relation to the oblique branch. Reasonable handling of oblique branch is the key to the success of the surgery.

Objective To investigate the expression of insulin-like growth factor Ⅱ mRNA-binding protein 3( IMP3 ) in transitional cell carcinoma of bladder( TCCB ) and its clinical significance. Methods The IMP3 expressions in 6 normal bladder tissues and 48 TCCB tissues were determined by immunohistochemistry staining, and the relationships between IMP3 expression and gender, age, pathological grading and staging were analyzed statistically. Results The positive expression rate of IMP3 was 62.5% ( 30/48 ) in bladder cancer,which were significantly higher than that in normal control ( 0/6 ) ( P ＜ 0. 05 ). The positive rate of IMP3 expression were significantly lower in superficial TCCB ( 46. 15%, 12/22 ) or early TCCB [ Grade Ⅰ 12. 5%(1/8) ,Grade Ⅱ 60. 0% (12/20) ] than that in invasive TCCB [T2 or above,81.8% (18/22) ] or advanced TCCB [ Grade Ⅲ ,85% ( 17/20 ) ] ( Ps ＜ 0. 05 ). Conclusion IMP3 is a promising biomarker for eraly detection and assessment of the malignancy degree in TCCB.

BACKGROUND:Toxic cytarabine is often used to prepare highly purified neurons in experimental studies addressing central nervous system diseases. However, the intervention time of cytarabine is little reported. OBJECTIVE:To determine the optimal intervention time of cytarabine(final concentration 10μmol/L) in primary culture of rat cortical neurons. METHODS:Rat primary cortical neurons were cultured in Neurobasal+B27 medium, and 10μmol/L cytarabine were added at 12, 24, 36 and 48 hours after culture, respectively. Half of the medium were changed every 48 hours. The morphology of neurons was observed under inverted microscope at 7 days. The purity and differentiation of neurons maturity were identified by immunocytochemistry method of neuron specific enolization enzyme staining. Morphometric analysis for all neuron-specific enolase positive cells was performed by Multifunction Computer Image Analysis System. RESULTS AND CONCLUSION:After addition of cytarabine at 24 hours of culture, the purity of neurons was more than 90%, well-differentiated cortical neurons accounted for 89.00%, and the area of neuronal body was the largest with the longest synapses. There were more neuron cells with transparent cytoplasm, and large nucleus. The cell body had good refraction and strong stereo sense. The neurons with 3-4 synapses and 3-4 bifurcates formed a good network structure. These results illustrate that although it willbe beneficial for the purity of neurons to add cytarabine early in neuron culture process, it will make obvious effect on neuronal differentiation. The highly purified and well-grown cerebral cortical neurons will be obtained after cultured in neurolbasal medium, which cytarabine is added to at 24 hours of culture.

Objective To explore the efficacy of simultaneous reconstruction of composite tissue defects in two adjacent metacarpophalangeal joints of hand by split the 2nd toes.Methods From December 2006 to December 2011,the second toe composite flap pedicled with the dorsalis pedis artery-first,second metatarsal dorsal artery-dorsal artery were designed,and split it into the second metatarsophalangeal joint composite flap pedicled with the dorsalis pedis artery-first dorsal metatarsal artery-tibial artery and the proximal interphalangeal joint composite flap pedicled with dorsalis pedis artery-second dorsal metatarsal arteryfibular dorsal artery.Then they were used to repair composite tissue defects in two adjacent metacarpophalangeal joints of hand at the same time after reconstruction.Results This group includes 14 metacarpophalangeal joints of 7 cases,twelve joints was successful,two joints of 1 case to give up because the first dorsal metatarsal artery variation.At 6-24 months follow-up study in 12 out of 14 cases showed that there was no joint degeneration in X-ray manifestation and the recovering of joint function was satisfying.According to the function evaluation standard of reconstraction of thrumb and finger issued by Hand Surgery Society Chinese Medical Association,the excellent and good rate was 83.3％.Conclusion It is feasible to reconstruct of composite tissue defects in two adjacent metacarpophalangeal joints of hand at the same time by split the 2nd toes,and can effectively improve the functions of injury metacarpophalangeal joint.